Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

Compliance Rules
#1
What are these and where do they come from?
2004-Bon Jovi
it'll take more than a doctor to prescribe a remedy

Observations and recommendations communicated here are the perceptions of the writer and should not be misconstrued as medical advice.
Post Reply Post Reply
#2
I don't remember the total package but it's at least 4 hours? for like 90% of the time over 30 days. best I can remember but someone will correct if wrong

they are only used by insurance, including medicare, for them to pay for the machine or take it back
Post Reply Post Reply
#3
(02-26-2016, 07:33 PM)0rangebear Wrote: What are these and where do they come from?

Orangebear,
Medicare requires a data report from the patients (PAP) device which documents use of said device for at least 4 hours per night on 70% of nights for a 30 consecutive day period during the first 90 days after starting treatment. For example, if a patient starts (PAP) treatment on January 1st and from January 30th to February 28th they use the device every night. If 21of the 30 nights the patient used the device for at least 4 hours then they are considered to be compliant.

Medicare also requires all (PAP) patients must have a face to face visit with their physician during the second or third month of using their (PAP) device. (Between day 31 and 90 after starting on the PAP treatment) During this visit the patients physician must document an improvement of systems. This means is imperative that patients make follow up appointments to meet with their physician prior to the 90 day cut off.

Even if your not on Medicare, most insurances follow Medicare guidelines.


Post Reply Post Reply


#4
The rules typically come from the insurance company. They don't want to pay for this machine without proof you are using it. They don't care if it is actually working out as adequate treatment or not, just that you are using it. Like PoolQ said, it is usually for x percentage a night for anywhere from 30 to 90 days which equal about 4hrs a night.

Sometimes an employee will want to see compliance data as well.

You cannot simply turn on a machine and let it run for 4 hrs and call it done. These newer ones can tell if a person is attached to the other end and will not count that time.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




Post Reply Post Reply
#5
Ha ha! Welcome to the club. I just got my first insurance replacement since 2008 and am back on compliance monitoring. considering my minimum use is 7.5 hours and average use is over 8-hours per night, this is not a problem. Use the machine (it's good for you), and the compliance will fall right into place. At some point in the first 90 days you need to meet with your doctor and discuss this therapy and persuade him that it is benefiting you. That should not be too difficult. Do this and you're home free with your machine. Failure is not an option.
Post Reply Post Reply
#6
(02-26-2016, 08:07 PM)Sleeprider Wrote: Ha ha! Welcome to the club. I just got my first insurance replacement since 2008 and am back on compliance monitoring. considering my minimum use is 7.5 hours and average use is over 8-hours per night, this is not a problem. Use the machine (it's good for you), and the compliance will fall right into place. At some point in the first 90 days you need to meet with your doctor and discuss this therapy and persuade him that it is benefiting you. That should not be too difficult. Do this and you're home free with your machine. Failure is not an option.

Wow! I don't knowThinking-about how you do it. I cant ever remember sleep 7.0 hour let alone 8. I am usually wide awake between 5 and 6 hours. I have tried to sleep longer just unable.

2004-Bon Jovi
it'll take more than a doctor to prescribe a remedy

Observations and recommendations communicated here are the perceptions of the writer and should not be misconstrued as medical advice.
Post Reply Post Reply


#7
I'm such a slouch in retirement. My Sleepyhead data shows 8.42 hours average for the last year with 100% compliance. Dont-know
Post Reply Post Reply
#8
(02-27-2016, 07:57 PM)Sleeprider Wrote: I'm such a slouch in retirement. My Sleepyhead data shows 8.42 hours average for the last year with 100% compliance. Dont-know

I envy you my friendCoffee My Dr. prescribed 5 hours a night 6 days on a week on the machine. This a bit different that the compliance stats in sleepyhead. Sounds like it must of actually come from my insurance company. I just hit my 60th day yesterday and it looks like I am on the fence on the compliance issue.
2004-Bon Jovi
it'll take more than a doctor to prescribe a remedy

Observations and recommendations communicated here are the perceptions of the writer and should not be misconstrued as medical advice.
Post Reply Post Reply
#9
(02-27-2016, 10:37 PM)0rangebear Wrote:
(02-27-2016, 07:57 PM)Sleeprider Wrote: I'm such a slouch in retirement. My Sleepyhead data shows 8.42 hours average for the last year with 100% compliance. Dont-know

I envy you my friendCoffee My Dr. prescribed 5 hours a night 6 days on a week on the machine. This a bit different that the compliance stats in sleepyhead. Sounds like it must of actually come from my insurance company. I just hit my 60th day yesterday and it looks like I am on the fence on the compliance issue.

Well no wonder! You're drinking coffee late at night! Try this. Eat-popcorn
Post Reply Post Reply




Possibly Related Threads...
Thread Author Replies Views Last Post
  Do I still meet the 4 hour a night compliance if my mask leaks? UKwildcatfan 4 197 03-18-2017, 01:25 AM
Last Post: Ockrocket
  Compliance for Medicare supplies jrh0 6 144 03-16-2017, 08:57 PM
Last Post: trish6hundred
Question [CPAP] Compliance Software graeme 9 3,652 03-12-2017, 07:53 AM
Last Post: OpalRose
  Compliance - so what? Hydrangea 19 926 02-24-2017, 10:45 PM
Last Post: Hydrangea
Question How do new medicare rules impact sleeplabs justMongo 3 205 02-21-2017, 09:38 PM
Last Post: Sleeprider
  Compliance question. Do I need to have a follow up if I paid out of pocket? Piggles 7 319 02-06-2017, 05:19 PM
Last Post: Joe Fox
  ResScan Compliance Report BobF 2 327 12-22-2016, 10:55 AM
Last Post: BobF

Forum Jump:

New Posts   Today's Posts




About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.

For any more information, please use our contact form.